WHO supports GAVI Board decision to open a funding window for human papillomavirus and rubella vaccines

17 November 2011

"The decision by the GAVI Board to invite countries to apply for funding for introduction of human papillomavirus and rubella vaccines is great news for developing countries. The protection afforded by the HPV vaccine will save many more women from the pain and suffering caused by cervical cancer. Availability of funding for rubella vaccine will prevent the severe birth defects that result from rubella infection in early pregnancy and give a much-needed boost to countries' efforts to eliminate both measles and rubella."

The opening of new GAVI "funding windows" for human papillomavirus and rubella vaccines means that the 57 countries eligible for support from the GAVI Alliance can apply for funding to introduce these vaccines in their immunization programmes. The GAVI Board's decision is in accordance with WHO recommendations on inclusion of both vaccines in national immunization programmes. As is the case for other funding windows, only vaccines prequalified by WHO will be supplied to countries using funds from the GAVI Alliance.

WHO will continue to collaborate with national immunization programmes planning to introduce these vaccines, providing technical support in the areas of logistics management, reaching age groups beyond infancy, and setting up effective systems for monitoring of adverse events following immunization.

WHO recommendation on human papillomavirus vaccines

WHO recommends routine vaccination of young adolescent girls to protect against human papillovirus (HPV), which causes cervical cancer, in all countries where the prevention of cervical cancer and/or other HPV-related diseases is a public health priority, vaccine introduction is programmatically feasible, sustainable financing can be secured, and the cost-effectiveness of vaccination strategies in the country or region has been duly considered.

General information on HPV

Cervical cancer is responsible for over a quarter of a million deaths and over 500 000 new cases each year. It is one of the leading causes of cancer among women, with more than 85% of the global disease burden resulting from HPV infection in developing countries. Most cervical cancer cases occur in women aged over 40, an age when women maximize their contributions to families, economies and communities. HPV infections are transmitted through sexual contact.

Two HPV vaccines are now being marketed in many countries throughout the world. Both vaccines are highly efficacious in preventing infection with virus types 16 and 18, which are together responsible for approximately 70% of cervical cancer cases globally. They are also highly efficacious in preventing precancerous cervical lesions caused by these types. One vaccine is also highly efficacious in preventing anogenital warts, a common genital disease which is virtually always caused by infection with HPV types 6 and 11.

Other HPV vaccines are in the vaccine development pipeline and are expected to be licensed in the coming years.

WHO recommendation on rubella vaccines

WHO recommends that all countries that have not yet introduced rubella vaccine, and are providing two doses of measles vaccine using routine immunization and/or supplementary immunization activities consider introducing rubella vaccine.

General information on rubella

Transmitted through airborne droplets, rubella is generally a mild illness. However, when a pregnant woman becomes infected particularly during the first trimester, serious consequences can occur including miscarriages, still births, and infants born with birth defects known as Congenital Rubella Syndrome (CRS). The most common congenital defects include heart problems, deafness or blindness (cataracts). CRS remains a major public health problem with an estimated 112 000 cases occurring globally, of which 90 000 are in "GAVI eligible" countries.

While large-scale rubella vaccination during the last decade has enabled the elimination of rubella and CRS in the Western Hemisphere and several European countries, the current burden of CRS in Africa, South-East Asia and the Western Pacific regions is still thought to be high.